Labour, Delivery and Puerperium

Question 1

Define labor.

Answer 1

Labor is defined as progressive cervical effacement, dilatation, or both resulting from regular uterine contractions.

Question 2

What are the criteria for established labour?

Answer 2

Labour is established if there are 2 contractions, each lasting for >20secs, observed in 10mins.

Question 3

What is Braxton Hicks contraction?

Answer 3

Braxton Hicks contractions are considered false labor as the are not associated with progressive cervical dilatation or effacement.

Question 4

What is the purpose that Braxton Hicks contractions serve?

Answer 4

Braxton Hicks contractions are practice contractions that prepares the uterus and cervix for true labor.

Question 5

When does Braxton Hicks contractions usually occur?

Answer 5

Braxton Hicks contractions usually occur early in the third trimester of pregnancy (weeks 28 to birth), more commonly after week 36

Question 6

What heralds the onset of labor?

Answer 6

The release of the mucus plug as a small amount of blood-tinged mucus discharge from the vagina heralds the onset of labor

Question 7

Why does cervical effacement occur?

Answer 7

Cervical effacement occurs due to increased water content and collagen lysis.

Question 8

Describe what the first stage of labor consist of?

Answer 8

The first stage of labor occurs from the onset of true labor to the complete dilatation of the cervix

Question 9

What are the 2 phases of the first stage of labor?

Answer 9

Latent phase and active phase

Question 10

Define molding and caput

Answer 10

Molding is the alteration of the relationship of the fetal cranial bones to each other as a result of compressive forces exerted by the bony maternal pelvis.

Caput is a localised, oedematous swelling of the scalp caused by pressure of the cervix.

Question 11

How many movements are there which helps the fetus to adapt to the maternal pelvis?

Answer 11

6 movements

Question 12

What are the movements of the fetus as it adapts to the maternal pelvis?

Answer 12

Descent, flexion, internal rotation, extension, external rotation and expulsion

Question 13

What occurs during internal rotation?

Answer 13

The fetal head, which was initially in the oblique diameter, will rotate 90 degrees, positioning the occiput anteriorly to face the pubic symphysis.

Question 14

What is the term to describe the procedure of an incision in the perineum to aid in reducing perineal resistance and tearing of perineal tissues?

Answer 14

Episiotomy refers to an incision made in the perineum to help in delivery of the baby.

Question 15

How are perineal lacerations classified?

Answer 15

First degree: A laceration involving the vaginal epithelium or perineal skin
Second degree: A laceration extending into the subepithelial tissues of the vagina or the perineum with or without involvement of the muscles of the perineal body
Third degree: A laceration involving the anal sphincter
Fourth degree: A laceration involving the rectal mucosa

Question 16

Normal labor occurs after how many weeks of gestation?

Answer 16

Normal labor occurs after 37 weeks of gestation

Question 17

Describe the duration of each trimester in pregnancy in terms of weeks.

Answer 17

1st trimester: weeks 1 to 12 (from day of last menstrual period)
2nd trimester: weeks 13 to 27
3rd trimester: weeks 28 to birth

Question 18

What is labor also known as?

Answer 18

Parturition

Question 19

What does effacement mean?

Answer 19

Effacement of the cervix refers to the cervix becoming shorter and thinner

Question 20

During the latent phase of the 1st stage of labor, how much did the cervix dilate and efface?

Answer 20

In the latent/early phase of the 1st stage of labor, the cervix dilates from 0cm to 3cm, and effacement is about 30%

Question 21

During the active phase of the 1st stage of labor, how much did the cervix dilate and efface?

Answer 21

In the active phase of the 1st stage of labor, the cervix dilates from 3cm to 7cm, and effacement is about 80%

Question 22

During the transition state of the 1st stage of labor, how much did the cervix dilate and efface?

Answer 22

In the transition phase of the 1st stage of labor, the cervix dilates from 7cm to 10cm, and effacement is 100%